Provider Demographics
NPI:1740803394
Name:CONRAD CARE INC
Entity type:Organization
Organization Name:CONRAD CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:EFOSA
Authorized Official - Last Name:AGBONIFO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-240-9225
Mailing Address - Street 1:3525 W PETERSON AVE STE 505
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-3317
Mailing Address - Country:US
Mailing Address - Phone:312-204-7255
Mailing Address - Fax:872-228-8606
Practice Address - Street 1:3525 W PETERSON AVE STE 505
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-3317
Practice Address - Country:US
Practice Address - Phone:312-204-7255
Practice Address - Fax:872-228-8606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-18
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health